By Mary Kuhlman
Heroin use and abuse in the U.S. is rising among most age groups and income levels, according to a recent report from the CDC.
Young adults have seen the fastest rise in heroin abuse, more than doubling previous numbers. CDC director Dr. Tom Frieden says the reasons behind the rise are complicated, but one thing is clear - a connection to opioid prescription painkiller addiction.
"The chemical is essentially the same," he says. "When heroin is five times cheaper and much more widely available, it becomes something that's driving this trend of rapid increase in heroin use."
It may be a case of unintended consequences, as Frieden says prescription painkillers became harder to obtain after limits were imposed because of addiction concerns. The CDC report says 45 percent of those who have used heroin had been dependent on prescription painkillers, while another finding revealed people without health coverage are more likely to use heroin.
There's also been a national uptick in heroin overdose deaths, with more than 8,000 in 2013.
According to the Indiana State Department of Health, heroin-related deaths in 2013 were nearly three times higher than in 2010. Frieden says quality and potency varies on the street, and overdose-reverse medications aren't always readily available in emergency rooms - which he says needs to change.
Frieden also underscores the need to keep opioid painkillers as medical treatment options, despite the heroin connection, with pros and cons weighed carefully.
"If someone has excruciating pain from a surgical procedure, or a car crash, or a severe, terminal pain from cancer, you absolutely want to provide all palliation," he says. "For chronic non-cancer pain, you really have to look at the risks and the benefits."
Recommendations for stemming the tide of heroin abuse include increased access to treatment and medication-assisted treatments, recognition of the link between past prescription painkiller dependence and future heroin use, and pain treatment plans for chronic sufferers that include options beyond medications.